At his weekly press conference, House Speaker Paul Ryan explained the merits and goals of the American Health Care Act, the reconciliation process, and health reform.
SPEAKER PAUL RYAN: First of all, I would like to walk you through exactly what the American Health Care Act is. I want to walk you through exactly what this health care law is, and what we're replacing, and how important it is to repeal and replace Obamacare, not just because the law is collapsing, but because the law is going to get even worse if we do nothing.
Let me show you what our problem is and what we're trying to do. We are going to repeal and replace Obamacare and we're going to do it with a three-pronged approach. Number one is what we're talking about right now. This is what the Ways and Means Committee marked up this morning; what the Commerce Committee is in the middle of right now.
That's called reconciliation. That's the American Health Care Act. There are only so many things you can do in that bill because of the Senate floor rules for reconciliation. You can't put everything you want in that legislation because if you did, it would be filibustered and you couldn't even bring it up for a vote in the Senate.
Number two, administrative action. This law, Obamacare, has 1,442 sections or instances that gives the secretary of HHS enormous amounts of discretion to administer health care, meaning I don't think Barack Obama, Nancy Pelosi and Harry Reid when they crammed this bill through ever thought Donald Trump would be president and Tom Price would be the secretary of HHS.
So, number two in our three-pronged approach, administrative action where the health and human services secretary deregulates the marketplace and allows more choice and more competition to come in the marketplace.
Number three, and this is where I think there's a lot of confusion all over the map -- additional legislation that we feel is important and necessary to give us a truly competitive health care marketplace. So, think of things like interstate shopping. That's a reform that we've long believed in; that we think is really important to get regulatory competition to give people even more choices.
Association health plans -- let a farmer buy her insurance through the National Farm Bureau plan, or a restaurateur buy his insurance for he and his employees through the National Restaurant Association plan on a nationwide basis. Let small businesses buy their insurance through the NFIB plan nationwide.
We would love for that to be in this reconciliation bill, but the rules in the Senate don't allow that to happen. So we're going to move those bills independently. We're going to move those bills at the same time through our process and bring those to a vote. Unfortunately, they'll have to hit what we call the 60-vote threshold.
So we have a three-pronged approach -- a three-pronged approach to repealing and replacing Obamacare.
Let's get into why this needs to happen and why it needs to happen now. Options are disappearing fast. This law is in the middle of a collapse and people are quickly losing their choices. In 2016, the amount of counties in America that had three or more insurers, three or more carriers to choose from, was about 2,000. In 2017, that number has plummeted. Insurers are leaving the marketplace. Choice and competition is going away. And people are having less choices.